42 CFR 405.1835 - Right to Board hearing; contents of, and adding issues to, hearing request

Cite as42 CFR 405.1835
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139 practice notes
121 cases
  • Maximum Home Health Care, Inc. v. Shalala, No. 3:99-0299.
    • United States
    • United States District Courts. 6th Circuit. United States District Court of Middle District of Tennessee
    • July 27, 2000
    ...is at least $10,000, the provider may request a hearing before the Provider Reimbursement Review Board (PRRB). 42 U.S.C. § 1395oo(a); 42 C.F.R. § 405.1835. Within 60 days after a PRRB decision, the Secretary, on her own motion, may reverse, affirm or modify that decision. 42 U.S.C. § 1395oo......
  • California Seniors v. Catholic Healthcare, No. B140639.
    • United States
    • California Court of Appeals
    • February 28, 2001
    ...federal district court—but the PRRB's or Administrator's decision will be given considerable deference. (42 U.S.C. §§ 1395ii, 405(h); 42 C.F.R. §§ 405.1835, 405.1842, 405.1873-405.1885; Good Samaritan Hospital v. Shalala, supra, 508 U.S. at pp. 417-418, 113 S.Ct. 2151 [a court should be "es......
  • Bartlett Memorial Medical Center, Inc. v. Thompson, No. 02-6142.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (10th Circuit)
    • October 20, 2003
    ...but for which the hospital has a jurisdictionally proper appeal pending on this issue pursuant to either 42 C.F.R. § 405.1811 or 42 C.F.R. § 405.1835, these days may be included for purposes of resolving the 5. The mandamus statute states: The district courts shall have original jurisdictio......
  • Battle Creek Health System v. Leavitt, No. 06-1775.
    • United States
    • United States Courts of Appeals. United States Court of Appeals (6th Circuit)
    • August 14, 2007
    ...the Secretary's Provider Reimbursement Review Board ("PRRB"), within 180 days of receipt of the NPR. 42 U.S.C. § 1395oo(a), (b); 42 C.F.R. §§ 405.1835, 405.1837. The PRRB's decision is subject to review, upon written request by one of the parties, by the Deputy Administrator of CMS (the "Ad......
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13 firm's commentaries
  • Changes Proposed to PRRB Dissatisfaction Requirement
    • United States
    • JD Supra United States
    • June 5, 2014
    ...of program reimbursement (NPR), for the cost period at issue. Pursuant to 42 U.S.C. §§ 1395oo(a)(1)(A), (a)(2), and (a)(3), and 42 C.F.R. §§ 405.1835(a)(1), (a)(2), and (a)(3)(i), a provider may obtain a hearing before the Board if: (1) the provider is “dissatisfied” with the final determin......
  • Court Rejects CMS's "Predicate Facts" Position
    • United States
    • JD Supra United States
    • July 16, 2018
    ...Similarly, the statutes and regulations governing appeals do not incorporate the rules for reopenings. See 42 U.S.C. § 1395oo(a) and 42 C.F.R. §§ 405.1835 and 405.1837. And while the PRRB review statute at 42 U.S.C. § 1395oo does make findings under certain sections non-reviewable, those se......
  • CMS Changes to Cost Report and Appeal Rules Are Now in Effect
    • United States
    • JD Supra United States
    • January 8, 2016
    ...that requirement a substantive cost report requirement. More specifically, in 2008, CMS had amended 42 C.F.R. § 405.1811(a)(1) and 42 C.F.R. § 405.1835(a)(1) to require, as a condition to filing an appeal, that the provider have either claimed an item in its cost report when seeking reimbur......
  • U.S. Supreme Court Holds Equitable Tolling Doctrine Does Not Apply To Administrative Appeal Deadline
    • United States
    • JD Supra United States
    • January 28, 2013
    ...decisions typically have 180 days from the time they receive an NPR to request a hearing. See 42 U.S.C. § 1395oo(a)(3); 42 C.F.R. § 405.1835(a)(3). This 180-day time period may be extended up to three years, though, for good cause. 42 C.F.R. § 405.1836; 42 C.F.R. § 405.1841(b)(2007). Becaus......
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